Paquier Laurine, Mihanović Jakov, Counil Antoine, Karlo Robert, Bačić Ivan, Dželalija Boris
School of Medicine, University Claude Bernard Lyon, France.
Department of Surgery, Zadar General Hospital, Croatia.
Trauma Case Rep. 2021 Mar 18;32:100469. doi: 10.1016/j.tcr.2021.100469. eCollection 2021 Apr.
Gas gangrene is infectious disease caused by infection. We are presenting extremely rare case of gluteal clostridial myonecrosis after intramuscular injection of diclofenac in immunocompromised young patient on a long-standing corticosteroid therapy presented with sepsis and initially absent clinical signs of severe anaerobic infection. After delayed diagnosis, she was treated with aggressive surgical removal of necrosed tissue and targeted antibiotic therapy which led to a rapid improvement allowing application of a negative-pressure wound therapy device with favorable outcome. This report shows the importance of timely diagnosis with pitfalls of imaging. It confirms that surgical debridement along with specific antibiotic therapy is the mainstay of treatment, but also promotes negative-pressure wound therapy which has proved convenient for accelerated closure of large incisions with tissue loss without any adverse effects or the need for complex reconstructive procedures.
气性坏疽是由感染引起的传染病。我们报告了一例极为罕见的病例，一名长期接受皮质类固醇治疗的免疫功能低下的年轻患者，在肌肉注射双氯芬酸后发生了臀部梭状芽孢杆菌性肌坏死，该患者出现败血症，最初并无严重厌氧菌感染的临床症状。在延迟诊断后，对她进行了积极的手术切除坏死组织和针对性抗生素治疗，这使得病情迅速改善，从而能够应用负压伤口治疗装置并取得了良好效果。本报告显示了及时诊断以及影像学陷阱的重要性。它证实手术清创术与特定抗生素治疗是主要的治疗方法，但也推广了负压伤口治疗，事实证明这种治疗方法便于加速闭合伴有组织缺损的大切口，且无任何不良反应，也无需进行复杂的重建手术。
